Cryoablation of Renal Fossa Recurrence After Radical Nephrectomy

Kristina D. Suson, M.D.,1
Howard Richard III, M.D.,2 and
Michael W. Phelan, M.D.1
1Division of Urology, University of Maryland Medical Center, Baltimore, Maryland.
2Division of Vascular and Interventional Radiology, University of Maryland School of Medicine, Baltimore, Maryland.

Abstract

Background and Purpose: Renal fossa recurrence of renal-cell carcinoma (RCC) after radical nephrectomy historically necessitates open surgical resection. Cryoablation provides a minimally invasive alternative to open resection for local recurrence. We describe our experience with percutaneous cryoablation in three patients who were experiencing fossa recurrence.

Patients and Methods: We retrospectively reviewed medical records of three patients with renal fossa recurrence of RCC who were treated with percutaneous cryoablation.

Results: Percutaneous cryoablation was well tolerated; no complications were noted, and patients were discharged within 23 hours. One patient needed an additional cryoablation procedure, and one patient underwent subsequent open extirpation. Metastatic disease developed in one patient, while the other two patients remain negative for disease by axial imaging and percutaneous biopsy. All patients are alive at 43 months (range 22–54 months).

Conclusions: Percutaneous cryoablation, a minimally invasive intervention, has low morbidity and may be offered as an alternative to extirpation, although long-term oncologic data are lacking.